摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并发慢性阻塞性肺疾病(COPD)的相关因素,为患者临床预后改善及病情控制提供参考依据。方法选择2011年2月—2014年3月就诊的266例OSAHS患者,按照是否合并COPD将患者分为单纯OSAHS组186例、重叠综合征组80例,统计并记录2组患者性别、年龄、BMI值、OSAHS患者病情分级、是否吸烟、合并原发性高血压、合并冠心病、合并糖尿病、合并肾功能不全、合并脑血管病,并比较2组患者肺功能指标(FEV1/FVC、FEV1)、动脉血气分析(Pa CO2、Pa O2)。结果经单因素比较,2组患者在年龄、BMI、肺功能、动脉血气分析、OSAHS分级、吸烟、原发性高血压、冠心病以及慢性肾功能不全9个因素上差异具有统计学意义(P<0.05);将上述单因素分析具有统计学意义的各因素进行Logistic多因素回归分析,结果显示,BMI(OR=3.180)、FEV1/FVC(OR=3.168)、吸烟(OR=2.803)以及Pa O2(OR=1.870)四个因素进入Logistic回归模型(P<0.05),为OSAHS患者并发COPD的独立危险因素。结论肥胖、肺功能损伤、吸烟以及低氧血症是影响阻塞性睡眠呼吸暂停低通气综合征患者并发慢性阻塞性肺疾病的独立危险因素,需引起临床工作者的关注。
Objective To explore the related factors of obstructive sleep apnea-hypopnea syndrome（ OSAHS） complicated by chronic obstructive pulmonary disease（ COPD）,so as to provide reference for the improvement of clinical prognosis and disease control. Methods All 266 cases of OSAHS patients in our hospital between February,2011 and March,2014 were enrolled,and were divided into OSAHS group（ n = 186） and overlap syndrome group（ n = 80） according to complication of COPD. The gender,age,BMI values,medical grading of OSAHS,smoking,primary hypertension,coronary heart disease,diabetes,renal dysfunction and cerebral vascular disease in both groups were recorded and analyzed. The lung function parameters（ FEV1/ FVC,FEV1） and arterial blood gas analysis（ Pa CO2,Pa O2） were compared. Results Univariate analysis showed that the difference in age,BMI,lung function,arterial blood gas analysis,medical grading of OSAHS,smoking,hypertension,coronary heart disease and chronic renal insufficiency were statistically significant（ P〈0. 05）; Logistic regression analysis showed that BMI,FEV1/ FVC,smoking and Pa O2 were the risk factors（ P〈0. 05）,which were the independent risk factor for COPD in OSAHS patients. Multivariate regression analysis showed that BMI（ OR = 3. 180）,FEV1/ FVC（ OR = 3. 168）,smoking（ OR = 2. 803） and Pa O2（ OR = 1. 870） were included into the Logistic regression model（ P〈0. 05）. Conclusion The obesity,lung function injury,smoking and hypoxia are the independent risk factors of obstructive sleep apnea hypopnea syndrome in patients with chronic obstructive pulmonary disease,which need more attentions to be paid by clinicians.
出处
《中华全科医学》
2016年第3期417-419,共3页
Chinese Journal of General Practice
作者简介
通信作者：罗遐杰，E-mail：hukou2000@hotmail．com
